A male case of primary biliary cirrhosis (PBC) with chronic thyroiditis, chronic pancreatitis and sicca syndrome

A male case of primary biliary cirrhosis (PBC) with chronic thyroiditis and chronic pancreatitis is reported. A 66-year-old man was admitted, because of general fatigue and hepatomegaly. Laboratory data showed high level of serum Al-P (28.5 K-Au) and slight liver dysfunction. Serum anti-mitochondrial antibody and anti-thyroidal antibodies were positive. Rarely-identified precipitating antibodies to mitochondrial antigens such as M-C and M-D were detected by double immunodiffusion method, and especially the latter has been first discovered in Japan in this case. Biopsy of thyroid gland showed chronic thyroiditis (lymphocytic thyroiditis) and liver wedge biopsy proved typical chronic non-suppurative destructive cholangitis. Pancreas function was moderately disturbed and O-GTT showed diabetic pattern. Sicca syndrome appeared later. Thus, we finally diagnosed this case as PBC with chronic thyroiditis, chronic pancreatitis and sicca syndrome. We presented a male case of PBC with multisystem involvement and unusual mitochondrial antibodies (M-C and M-D system) in this report.